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Social differences in health: life-cycle effects between ages 23 and 33 in the 1958 British birth cohort.

C Power, C Hertzman, S Matthews and O Manor

Department of Epidemiology and Biostatistics, Institute of Child Health, London, England.

OBJECTIVES: The purpose of this study was to determine whether social differences in health persist or widen during early adulthood. METHODS: A longitudinal follow-up of the 1958 British birth cohort was investigated, using social class at birth and six health measures at ages 23 and 33. A slope of inequality was estimated to represent social differences in health. RESULTS: Social gradients in health were evident by age 23: the prevalence of poor health increased with decreasing social position. This was observed for several but not all health indicators. Social gradients persisted to age 33. The slope of inequality was greatest for malaise (odds ratio [OR] = 3.37 for men, 3.21 for women) and obesity (OR = 4.80 for men and 2.84 for women), both at age 23, and for self-rated health in women at age 23 (OR = 2.94) and age 33 (OR = 3.22). Inequality increased significantly between ages 23 and 33 for limiting illness in men, and lessened, although not significantly, for malaise, overweight, and obesity; social gradients remained constant for self-rated health, respiratory symptoms, and asthma or wheezing. CONCLUSIONS: Social gradients in health evident in this sample by age 23 persisted to age 33. Inequalities did not appear to widen consistently, but variable findings for several health measures suggest that inequalities reproduce through different pathways.

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